Pulmonary-Critical Care Medicine Division, St Elizabeth's Medical Center, Boston, MA 02115, USA.
Respir Res. 2012 Aug 20;13(1):71. doi: 10.1186/1465-9921-13-71.
The relationship between serum biomarkers and clinical expressions of COPD is limited. We planned to further describe this association using markers of inflammation and injury and repair.
We studied lung function, comorbidities, exercise tolerance, BODE index, and quality of life in 253 COPD patients and recorded mortality over three years. Serum levels of Interleukins 6,8 and16, tumor necrosis factor alpha (TNF α) [inflammatory panel], vascular endothelial growth factor (VEGF), and matrix metalloproteinase 9 (MMP-9) [injury and repair panel] and pulmonary and activation-regulated chemokine (PARC/CCL-18) and monocyte chemotactic protein 1 (MCP-1/CCL2) [chemoattractant panel] were measured. We related the pattern of the biomarker levels to minimal clinically important differences (MCID) using a novel visualization method [ObServed Clinical Association Results (OSCAR) plot].
Levels of the inflammatory markers IL-6, TNF α were higher and those of injury and repair lower (p < 0.01) with more advanced disease (GOLD 1 vs. 4). Using the OSCAR plot, we found that patients in the highest quartile of inflammatory and lowest quartile of injury and repair biomarkers level were more clinically compromised and had higher mortality (p < 0.05).
In COPD, serum biomarkers of inflammation and repair are distinctly associated with important clinical parameters and survival.
血清生物标志物与 COPD 的临床表型之间的关系有限。我们计划使用炎症和损伤及修复标志物进一步描述这种关联。
我们研究了 253 例 COPD 患者的肺功能、合并症、运动耐量、BODE 指数和生活质量，并记录了 3 年内的死亡率。记录了血清白细胞介素 6、8 和 16、肿瘤坏死因子 α（TNFα）[炎症标志物]、血管内皮生长因子（VEGF）和基质金属蛋白酶 9（MMP-9）[损伤和修复标志物]以及肺和激活调节趋化因子（PARC/CCL-18）和单核细胞趋化蛋白 1（MCP-1/CCL2）[趋化因子标志物]的水平。我们使用一种新的可视化方法[观察到的临床关联结果（OSCAR）图]将生物标志物水平的模式与最小临床重要差异（MCID）相关联。
随着疾病的进展（GOLD 1 与 4），炎症标志物 IL-6、TNFα 的水平更高，而损伤和修复的标志物水平更低（p<0.01）。使用 OSCAR 图，我们发现炎症标志物最高四分位数和损伤及修复标志物最低四分位数的患者在临床上更受影响，死亡率更高（p<0.05）。
在 COPD 中，炎症和修复的血清生物标志物与重要的临床参数和生存明显相关。
